This invention relates generally to the field of medical tests and specifically to hearing tests. More specifically the invention relates to a self-administered hearing test provided over the Internet.
Hearing loss can occur at all ages. Causes include environmental, such as from repetitive exposure to very loud music or other external noise; medical, including that caused by nerve damage, tumor or drug toxicity; genetic; and injury, such as may occur from rupture of the tympanic membrane of the ear. A major challenge in treating hearing loss is early identification. Conventional hearing testing generally requires sophisticated equipment, or testing at dedicated centers by experienced personnel.
The use of audiometric instruments in the screening and characterizing of human hearing is commonly found in schools, clinics, and in the offices of hearing aid dispensing professionals. Audiometric instruments employ pure tones, speech, and other stimuli that are within the audible range of human hearing. These sounds are delivered to the ear vicinity through transducers that are attached to the output portion of the audiometry instrument via cables.
Sound can be delivered to the ear by air-conduction transducers, such as supra-aural earphones housed in headsets, through bone-conduction transducers which make direct contact with the temporal bone area located immediately behind the ear, or by other means. Specifications and calibration standards for audiometers are available from agencies such as the American National Standards Institute (ANSI) which also provide a basis for classifications of audiometry instruments.
Recently available computer-based audiometric instruments are employed to facilitate testing procedures and improve patient records management. Automatic audiometers are becoming widely accepted in hearing screening applications such as in schools and industrial clinics. This automated process approach results in minimal operator involvement, faster testing, and in some instances improved accuracy.
Portable versions of automatic audiometry instruments incorporate microprocessors and miniature electronic components with innovative packaging and manufacturing technology to produce compact and light weight instruments suitable for most portable applications. While the cost and size of electronic components continue to decline, audiometry instruments still have at least two basic system components: a desk top electronic module connected via a cable to a separate standardized headset module to be worn on the patient""s head.
Slavin, U.S. Pat. No. 4,489,610, discloses the major elements of a computerized audiometer which may be operated automatically or by a technician. The device is housed in a cabinet which contains keyboard, printer and display devices. The apparatus disclosed also includes tone generator circuits, tape recorder based audible instruction generator, central processing unit, Read Only Memory (ROM) for storage of software, Random Access Memory (RAM) for storage of diagnostic data, and further includes a programming output port for coupling to a programmable hearing aid. Other options include interface ports to connect with a modem, remote printer, and data storage devices. Similar to all other audiometry instruments, the Slavin computerized audiometer has a patient operated switch in addition to cable connected transducers (headset) to be worn by the patient.
Besserman, U.S. Pat. No. 4,284,847, discloses an audiometry apparatus which is microprocessor-based. The apparatus includes tone generation means with variable frequency and intensities, various memory elements for software and patient data storage, a key-board, and a display device. The apparatus has interface capabilities with remote computers for data transfer. One of the main features of the invention is the ability to compare recent audiogram data with previously acquired ones and automatically compute hearing threshold shifts.
U.S. Pat. No. 4,157,456 to Voss discloses an audiometric testing system having earphones, a patient feedback switch, a tone generation means which is controlled for both frequency and loudness, a memory for storage of diagnostic data, and data output means.
Voroba et al., U.S. Pat. No. 4,759,070, teach a patient controlled hearing test instrument with hearing aid programming capabilities. The system referred to as xe2x80x9cmaster hearing aidxe2x80x9d has both an operator and patient""s console. Both consoles are microprocessor based. The patient is presented with stimuli and using the provided console which is electrically attached to a patient-worn hearing aid via a cable, the patient can optimize hearing aid characteristics in terms of amplification and other performance characteristics. The system comprises a number of physical units, including four loudspeakers for environmental noise simulation. All units are interconnected by means of cabling. The stimuli are generated by standard tone generators, tape recorded background sounds, and verbal instructions to the patient.
U.S. Pat. No. 4,989,251 to Mangold teaches a hearing aid programming method, and U.S. Pat. No. 4,961,230 to Rising teaches a hearing aid programming interface method having a battery compartment adapted to hold a coupler member for connection to an external programming device.
It is well known in the hearing diagnostic field that even though improvements in the reliability of transducer cabling continues, damage to the cabling and contact terminals remains to be a major problem. This failure leads to intermittent dysfunction which may lead to noisy and erratic sound transmission and possibly erroneous patient diagnosis. Even if the cabling damage is promptly detected, the audiometer must remain inoperable until a replacement or a repaired headset arrives.
Another disadvantage of the cabling associated with the present two-piece audiometer systems involves the limited mobility imposed on the patient wearing the headset who must remain close to the attached base instrument. Even the most portable types of audiometry instruments presently on the market impose a penalty on both the clinician who has to provide desk space to operate or store the audiometer and the associated headset and the patient who has to deal with cables which may get tangled with other cables and instruments in the clinical setup. This is particularly problematic with active children who have the tendency to move around and displace the critical placement of the headset on the ear.
Another less obvious but very significant disadvantage of the present desk-top or lap-top audiometer approaches involves the size reduction limitation imposed by the two-piece design. Although it may seem desirable and technically conceivable to make the audiometer extremely small and light weight using very large scale integration (VLSI) technologies, functionally it is highly undesirable because of the potential for the base instrument to be pulled and moved by the headset cable as the patient moves. Not only may this motion cause the instrument to drop and possibly break but this motion will also cause mechanical movements of the instrument to become acoustically coupled to the patient resulting in interference with the on-going tests and possibly invalidating threshold measurements. For this reason, most presently available audiometry instruments must maintain a minimum size and weight to stabilize the instrument while in operation.
A computer system is disclosed which is accessible to a community of users over the Internet. The system presents a screen or series of screens to users which (1) prompt the user to enter information such as user name and age, and (2) instructs the user on how to respond to sounds generated as a result of data sent to a user""s computer. A series of sounds at different frequencies and amplitudes are generated while the user blocks sound from reaching one ear and responds to sound detected such as by clicking a computer mouse or pressing a key on the keyboard. The system analyzes the responses relative to factors such as the user age and provides results to the user on the users hearing.
An aspect of the invention is that the hearing test can be self-administered.
Another aspect of the invention is that the test can be widely and economically distributed over the internet.
An advantage of the invention is that it does not require the use of expensive equipment.
A feature of the invention is that it can provide results to a user and/or the user""s caregiver in real time.
An object of the invention is to make a simple, low-cost, accurate hearing test available to users over the internet.
These and other aspects, objects, features and advantages will become apparent to those skilled in the art upon reading this disclosure.